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- Rosell, Axel, et al.
(author)
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Neutrophil extracellular trap formation is an independent risk factor for occult cancer in patients presenting with venous thromboembolism
- 2023
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In: Journal of Thrombosis and Haemostasis. - : Elsevier. - 1538-7933 .- 1538-7836. ; 21:11, s. 3166-3174
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Journal article (peer-reviewed)abstract
- Background: Venous thromboembolism (VTE), particularly unprovoked VTE, is associated with occult cancer. The optimal screening regimen remains controversial. Neutrophil extracellular traps (NETs) are implicated in cancer-associated thrombosis, and elevated biomarkers of NET formation are associated with poor prognosis.Objectives: To investigate the association between NET formation and occult cancer in patients with VTE.Methods: Blood biomarkers associated with NETs and neutrophil activation (nucleo-somal citrullinated histone H3 [H3Cit-DNA], cell-free DNA, and neutrophil elastase) were quantified in patients with VTE. The primary outcome was cancer diagnosed during a one-year follow-up.Results: This study included 460 patients with VTE, of which 221 (48%) had isolated deep vein thrombosis. Forty-three patients had active cancer at inclusion and were excluded from the primary analysis Cancer during follow-up was diagnosed in 29 of 417 (7.0%) patients. After adjustment for age and unprovoked VTE, the hazard ratio of cancer during follow-up per 500 ng/mL increase of H3Cit-DNA was 1.79 (95% CI, 1.03-3.10). Furthermore, patients with cancer-associated VTE (known active cancer or cancer diagnosed during follow-up) had higher levels of H3Cit-DNA than cancer-free patients with VTE after adjustment for age, hemoglobin, gender, chronic obstructive pulmonary disease, previous cancer, and start of anticoagulant treatment (odds ratio 2.06 per 500 ng/mL increase of H3Cit-DNA [95% CI, 1.35-3.13]).Conclusions: H3Cit-DNA is an independent predictor for occult cancer in patients with VTE and elevated in cancer-associated VTE, suggesting that H3Cit-DNA is potentially a useful diagnostic marker for cancer in patients with VTE and that elevated NET formation is a hallmark of cancer-associated VTE.
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| 2. |
- Westerlund, Runa, 1976-
(author)
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Idrottslärare i blivande : meningsskapande, kontinuitet och förändring i övergångar mellan utbildning och yrkespraktik
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Research and quality reports show a relatively unified picture of the school subject physical education (PE) as an educational context in which pupils are at risk of being marginalized or excluded. PE teacher education (TE) has a mission to equip all PE preservice teachers with knowledge and abilities that enable them to teach all pupils based on their individual needs and conditions. In this compilation thesis, I analyze the meaning-making process of becoming a PE teacher. I aim to study meaning-making as intertwined processes of learning and socialization in becoming a PE teacher while transitioning between a university-based and school-based context. The research questions addressed in the thesis include how encounters with PETE and work can be described and understood as well as what meaning-making is enabled and constrained in these encounters. The study employs a transactional understanding of meaning-making and a theoretical framework based on the work of John Dewey and on Occupational Socialization Theory (OST).The thesis comprises four articles, each emphasizing the individual and social dimensions of meaning-making processes analyzed in relation to cultural dimensions. In Article 1, I explore the challenges novice PE teachers face in Sweden and how they manage these challenges. In Article 2, I examine how PE teachers cope with challenges such as reality shock, marginalization, and isolation as novices and as more experienced teachers. Articles 1 and 2 present interview studies, revealing that the socialization process of PE teachers entering the profession relies more on the individual and on informal collegial support than on formal organizational support. In Article 3, I utilized lesson observations to explore how preservice PE teachers produce and reproduce knowledge when participating in PE TE. Finally, in Article 4, I use a series of interviews conducted over a year to investigate how preservice PE teachers make meaning of their participation in a subject didactics course and the practicum. The results in Articles 3 and 4 indicate that preservice PE teachers struggle to navigate dual purposes in the subject didactics course, namely developing movement capability and didactic capability simultaneously. However, through interactions with teacher educators and supervisors, the purpose of didactic theory becomes more accessible to preservice teachers based on their previous experience.Overall, the thesis illustrates that continuity and change are two sides of the coin in meaning-making processes. It demonstrates that preservice PE teachers are teacher oriented but require support in contextualizing their experiences. Furthermore, emotional experiences must be conceptualized to prevent teacher knowledge becoming tacit. The results of the thesis underscore that the development of an inclusive teacher perspective is achievable for PE preservice teachers and PE teachers, but they need additional support to cultivate a norm-critical teaching perspective for ensuring an education for all children and youth.
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